Prospective population-based study of RSV-related intermediate care and intensive care unit admissions in Switzerland over a 4-year period (2001-2005)

OBJECTIVES: Respiratory syncytial virus (RSV) infections are a leading cause of hospital admissions in small children. A substantial proportion of these patients require medical and nursing care, which can only be provided in intermediate (IMC) or intensive care units (ICU). This article reports on all children aged < 3 years who required admission to IMC and/or ICU between October 1, 2001 and September 30, 2005 in Switzerland. PATIENTS AND METHODS: We prospectively collected data on all children aged < 3 years who were admitted to an IMC or ICU for an RSV-related illness. Using a detailed questionnaire, we collected information on risk factors, therapy requirements, length of stay in the IMC/ICU and hospital, and outcome. RESULTS: Of the 577 cases reported during the study period, 90 were excluded because the patients did not fulfill the inclusion criteria; data were incomplete in another 25 cases (5%). Therefore, a total of 462 verified cases were eligible for analysis. At the time of hospital admission, only 31 patients (11%) were older than 12 months. Since RSV infection was not the main reason for IMC/ICU admission in 52% of these patients, we chose to exclude this subgroup from further analyses. Among the 431 infants aged < 12 months, the majority (77%) were former near term or full term (NT/FT) infants with a gestational age > or = 35 weeks without additional risk factors who were hospitalized at a median age of 1.5 months. Gestational age (GA) < 32 weeks, moderate to severe bronchopulmonary dysplasia (BPD), and congenital heart disease (CHD) were all associated with a significant risk increase for IMC/ICU admission (relative risk 14, 56, and 10, for GA < or = 32 weeks, BPD, and CHD, respectively). Compared with NT/FT infants, high-risk infants were hospitalized at an older age (except for infants with CHD), required more invasive and longer respiratory support, and had longer stays in the IMC/ICU and hospital. CONCLUSIONS: In Switzerland, RSV infections lead to the IMC/ICU admission of approximately 1%-2% of each annual birth cohort. Although prematurity, BPD, and CHD are significant risk factors, non-pharmacological preventive strategies should not be restricted to these high-risk patients but also target young NT/FT infants since they constitute 77% of infants requiring IMC/ICU admission.

Respiratory syncytial virus (RSV) SH and G proteins are not essential for viral replication in vitro: Clinical evaluation and molecular characterization of a cold-passaged, attenuated RSV subgroup B mutant

A live, cold-passaged (cp) candidate vaccine virus, designated respiratory syncytial virus (RSV) B1 cp-52/2B5 (cp-52), replicated efficiently in Vero cells, but was found to be overattenuated for RSV-seronegative infants and children. Sequence analysis of reverse-transcription–PCR-amplified fragments of this mutant revealed a large deletion spanning most of the coding sequences for the small hydrophobic (SH) and attachment (G) proteins. Northern blot analysis of cp-52 detected multiple unique read-through mRNAs containing SH and G sequences, consistent with a deletion mutation spanning the SH:G gene junction. Immunological studies confirmed that an intact G glycoprotein was not produced by the cp-52 virus. Nonetheless, cp-52 was infectious and replicated to high titer in tissue culture despite the absence of the viral surface SH and G glycoproteins. Thus, our characterization of this negative-strand RNA virus identified a novel replication-competent deletion mutant lacking two of its three surface glycoproteins. The requirement of SH and G for efficient replication in vivo suggests that selective deletion of one or both of these RSV genes may provide an alternative or additive strategy for developing an optimally attenuated vaccine candidate.

Results of Minicars RSV crash avoidance tests conducted in West Germany.

National Highway Traffic Safety Administration, Washington, D.C.

Research Safety Vehicle, RSV.

"March 1979."

Damageability tests of Minicars' RSV. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Results of a 30 degree angled barrier crash test on the Calspan RSV conducted in England.

National Highway Traffic Safety Administration, Washington, D.C.

Research safety vehicle (RSV) crash test report: test no. 3054-1 - 41 mph flat barrier frontal impact. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

RSV test monitoring and data publication - Renault R20TS-to-Calspan RSV 75 degree right side impact at Renault. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

RSV test monitoring and data publication - Renault R20TS-to-Calspan RSV 75 degree left side impact at Peugeot. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

RSV test monitoring and data publication - results of European performance and handling tests on the Calspan RSV. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Results of Minicars' RSV crash tests conducted in France - Renault R20 TS-to-Minicars' RSV 75 degrees left and right side impacts. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Consumer acceptance of RSV features - volume I: executive summary. Final report.

National Highway Traffic Safety Administration, Washington, D.C.

Consumer acceptance of RSV features - volume II: comprehensive report on 23 focus groups to investigate consumer acceptance of Research Safety Vehicle features. Final report.

National Highway Traffic Safety Administration, Washington, D.C.